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Being trans in Korea: key milestones and stigmatization across life stages in a nationwide survey of 585 transgender and non-binary young adults
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Sungsub Choo, Ranyeong Kim, Hyemin Lee, Horim Yi, Rockli Kim, Seung-Sup Kim
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Epidemiol Health. 2025;47:e2025032. Published online June 27, 2025
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DOI: https://doi.org/10.4178/epih.e2025032
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 Abstract
Summary
 PDF Supplementary Material
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Abstract
OBJECTIVES
Understanding the experiences of transgender and non-binary (TGNB) individuals from a life-course perspective is essential. This article aims to identify ages at key milestones related to transgender identity and assess experiences of stigmatization among TGNB individuals across different life stages.
METHODS We analyzed data from a nationwide longitudinal survey of 585 TGNB adults in Korea collected in 2020 and 2021. Analysis of variance and chi-square test were used to compare mean ages at transgender identity developmental milestones and experiences of anti-transgender stigma across transgender identities.
RESULTS On average, TGNB Koreans realized their transgender identity at age 13, accepted it at age 20, and came out to others at age 21. Regarding experiences of stigmatization across different life stages, 67.4% reported hearing homophobic and transphobic remarks from teachers in secondary school. Among TGNB individuals assigned male at birth (AMAB) who served mandatory military service, 29.0% were classified as maladjusted soldiers, and 12.1% experienced sexual harassment or violence. When asked about the job application process, 57.0% reported discontinuing their job search due to their transgender identity. Financial burden represented the primary barrier to psychiatric evaluations, hormone treatment, and gender-affirming surgery.
CONCLUSIONS Our study identifies key milestone ages related to transgender identity and experiences of stigmatization across life stages among TGNB adults in Korea. With 97.6% of participants under 40 years old, these findings primarily reflect the experiences of TGNB young adults. Further research is necessary to better understand the experiences of middle-aged and elderly TGNB individuals in Korea.
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Summary
Korean summary
한국에서 트랜스젠더 당사자들은 평균적으로 13살에 트랜스젠더 정체성을 자각하고, 20살에 트랜스젠더로서의 자신을 수용하며, 21살에 처음으로 트랜스젠더 정체성을 타인에게 알린다. 시스젠더 이성애자의 몸을 표준으로 구성된 한국 사회에서, 트랜스젠더는 청소년기와 성인기를 거치며 고등학교, 군 복무, 취업, 의료 이용 등에서 차별과 낙인을 경험한다.
Key Message
The average age of developmental milestones related to transgender identity include realizing their transgender identity at age 13, accepting it at age 20, and first coming out at age 21. TGNB individuals faced stigma and discrimination in key set- tings and situations such as secondary school, the military, and job applications from their adolescence and onwards.
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Individual- and neighborhood-level factors influencing diet quality: a multilevel analysis using Korea National Health and Nutrition Examination Survey data, 2010-2019
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Dahyun Park, Min-Jeong Shin, S V Subramanian, Clara Yongjoo Park, Rockli Kim
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Epidemiol Health. 2025;47:e2025043. Published online August 4, 2025
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DOI: https://doi.org/10.4178/epih.e2025043
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Abstract
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Abstract
OBJECTIVES
Although environmental factors influence lifestyle choices, few studies have examined how individual-level and neighborhood-level socio-demographic factors interact to affect diet quality in Korea. We investigated the associations between multilevel factors and diet quality among Korean adults and explored potential interactions by gender and age.
METHODS We conducted a cross-sectional analysis of 42,035 adults from 1,671 towns using data from the Korea National Health and Nutrition Examination Survey (2010-2019) and the Population and Housing Census of Korea (2010-2019). Individual-level variables included gender, age, education, income, number of household members, smoking, drinking, physical activity, and subjective health status. Neighborhood-level variables included residential area, housing type, number of restaurants per capita, population size, and the proportion of low-income households and older adults. Associations with the Korean Healthy Eating Index (KHEI) were assessed using 2-level hierarchical models.
RESULTS Of the total variance in KHEI, 5.2% was attributable to neighborhood-level differences. Individual-level factors explained 48.1% of variance at the neighborhood-level, while neighborhood-level factors accounted for an additional 12.4%. Individuals living in rural areas, non-apartment housing, neighborhoods with higher proportions of low-income households and older adults, or in areas with smaller populations, had lower KHEI scores than their counterparts. In random slope models with cross-level interaction terms, diet quality among adults aged 70 years and older varied significantly according to neighborhood- level characteristics.
CONCLUSIONS Both individual-level and neighborhood-level factors influence diet quality in Korea, with older adults being especially vulnerable to neighborhood characteristics. Multilevel approaches are needed to identify at-risk populations and improve dietary outcomes.
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Summary
Korean summary
한국에서 식이 질은 개인적 요인 뿐 만 아니라 지역사회 수준 요인에 의해서도 유의하게 영향을 받는다. 농촌 거주, 비아파트 주거, 저소득층 또는 고령 인구 비율이 높은 지역에 거주하는 경우 한국 건강식이 지수(KHEI) 점수가 낮게 나타났다. 특히 노인은 불리한 지역사회 환경에 더욱 취약하여, 젊은 성인보다 더 강한 교차 수준 상호작용을 보였다.
Key Message
Both individual- and neighborhood-level factors significantly influence diet quality in Korea. Rural residence, non-apartment housing, and neighborhoods with higher proportions of low-income or elderly residents were associated with lower Korean Healthy Eating Index (KHEI) scores. Older adults were especially vulnerable to adverse neighborhood environments, show- ing stronger cross-level interactions than younger adults.
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